Not just a women's problem: Osteoporosis also occurs in men

Thursday

Feb 28, 2008 at 12:01 AM

DEAR DR. DONOHUE: I often read of osteoporosis in your column, and usually the commentary is directed to women. I am a male, 80 years old, and have osteoporosis. I have had eight compression fractures of my spine. Two were taken care of by natural processes, whatever that is. The other six were treated with kyphoplasty. A writer asked you about Flomax, which I take. You told the writer to take calcium and vitamin D, too. Would I benefit from those?

Paul G. Donohue, M.D.

DEAR DR. DONOHUE: I often read of osteoporosis in your column, and usually the commentary is directed to women. I am a male, 80 years old, and have osteoporosis. I have had eight compression fractures of my spine. Two were taken care of by natural processes, whatever that is. The other six were treated with kyphoplasty. A writer asked you about Flomax, which I take. You told the writer to take calcium and vitamin D, too. Would I benefit from those?

— J.J.

Men definitely get osteoporosis. Women are more often affected because of their precipitous drop in estrogen production at menopause. Estrogen is essential for strong bones in women. In addition to menopause, aging is another factor involved in osteoporosis, and both men and women are affected by that. A man at age 60 has almost a 30 percent chance of developing osteoporosis before he dies.

Compression fractures are crumbling of backbones. The osteoporotic backbones have become so weak that they can't support body weight, and they are squashed from trying to hold it up. Reflecting that is a loss of height. People can lose as much as 2 inches of their maximum height because of compression fractures. Sometimes those fractures are quite painful; sometimes they produce no symptoms. Kyphoplasty entails injecting bone cement into a compressed backbone to restore its height and to relieve pressure on adjacent nerves that are often the source of pain.

The writer you cite was on Fosamax (alendronate), a frequently prescribed drug for osteoporosis. Flomax, your medicine, sounds like Fosamax, but Flomax is for an enlarged prostate gland. I told her she would benefit from taking calcium and vitamin D; so would you. You also might benefit from one of the osteoporosis drugs, like Fosamax. Ask your doctor about their suitability for you.

DEAR DR. DONOHUE: My wife doesn't remember your having written about Candida. She has diabetes and, many times throughout the years, she has requested testing for Candida, but to no avail. What is your opinion on this?

— O.R.

Candida is a yeast. All of us carry it in our digestive tracts and on our skin. It doesn't cause any trouble because it isn't there in large numbers. Sometimes, when people take antibiotics for an infection, the antibiotics kill off good bacteria that keep the Candida population in check. When those bacteria die, the Candida population explodes, and people can come down with mouth Candida infection (thrush), or women can develop a Candida vaginal infection. Diabetes also promotes Candida infections.

In the mouth, the infection consists of white patches on the tongue and cheeks. Vaginal Candida infections promote a discharge that varies from thick and white to pale and watery. Almost always, such a vaginal infection itches. Candida can pop up in other places as well.

Even though your wife has diabetes, she doesn't need testing for Candida unless she develops signs and symptoms of infection by this yeast. Not everyone with diabetes comes down with such an infection. Your wife has been lucky so far, and she probably will be just as lucky in the future.

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